Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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HOLLOW FRUSTUM REAGENT TEST DEVICE
Background of the Invention
Field of the Invention
This imrention relates to a meter and disposable device for measuring the
concentration of an analyze in a biological fluid; more particularly, an
apparatus for
which the disposable device is a hollow frustum.
~o
2. Des~i~ion of the Related Art
Medical diagnosis often involves measurements on biological fluids, such as
blood) urine) or saliva, that are taken from a patient. Ge~ally, it is
important to
avoid both contamination of equipment and personnel with these fluids and to
avoid
~ s contamination of the patient with fluids from others. Thus, there is a
need for
diagnostic devices that minimize the risk of such contamination.
Among the medical diagnostic devices that are in most widespread use today is
the blood glucose monitor. In the U. S. alone, there are an estimated 14
million
people with diabetes. In order to avoid serious medical problems, such as
vision loss,
2 o circulatory problems, kidney failure, ac., marry of these people monitor
their blood
glucose on a regular basis and then take the steps necessary to maintain then
glucose
concentration in an acceptable range.
Blood contamination is of concern when mating a blood glucose measurement.
For txample, when using the most common types of whole blood glucose milers
2 s (photometric), the glucose determination is generally made from a blood
sample that
is applied to a test strip that is on the meter. To apply the patient's finger-
stick blood
sample, the patient's finger must be positioned above and near to the test
strip in
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order to inoculate the test strip with the blood sample. There is a risk that
the
patient's finger may come into contact with a portion of the meter that is
cor,:anainated with blood from previous use by othersy particularly when used
u. a
hospital-
?his risk to the patient is avnier~ed if the test strip is inoarlated befog t
is
placed into the meter. This iS the so called "off-meter dosing" approach.
'Yrth ta.is
fiPPt~ P~~ ~P~ ~s blood sample to a reagent test scrip as the ~. stcp
in the measurement process. Then the strip is inserted into the meter- The
~~t's
finger only comes into wntau with a new (clean) disposable, which cannot be
io contaminated by another patient's blood. T'he finger never comes into cont~
~~ieth a
car~t3manatard portion of the recta. T"na approach of off meter dosing has
lscc:.~
for sore time) particularly arith meters that operate photometrically, as w~ ~
:n
systems that meauue h~toait. A di:~vartage of off meter dosing is tinatc ~:~e
meter cannot take a measuremcnt st or before "time-zsro", the time when the
sample
i s was applied to the strip. tn a photomet<-ic metes, a re~tance reading
prior to s~:rip
i.~oculation permits the metrr to f6r vari~ioaq in strip background co:~r and
pos~ior~ing. The meter can also dderr~ne time-za o more directly and more
acwratdy) which faalitates accurate measuremarts. By contest, time-zero ri~~
be
dif5cutt or impossible to detninir~e if t'ze strip is unoculated oil meter.
2 o Although off-meter dosing reduces the contamination problem for the
,;~:en:,
the e:eter can still become cont~c1 with blood. There is thus a risk to o~~~
who may come into contact with the cr~ntaminated meter, such as workers i~ a
hospital and meter repair technicians. Furthermore, if the patient is being ~
by
a healthcare worker, that w~orlcet could come into oorrtact with the patieat'a
blood
z~ wh~e removing the strip for disposal, sir the test has been completed-
Meters that operate docGrochemicsliy typicaJ>~r ase "remote dosing", ~ at~ich
tl-~e tit strip is piarxd in the meter b~3re inoailatioa, but the blood
appli~~ po~sc
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is remote from the meter surfaces that can become contaminated. For example,
the
Glucometer EGte~ from Bayer Diagnostics and the Advantage~ from Boehringer
Mannheim incorporate dectrodes with remote sample application. As with off
meter
dosing, strip removal may also pose a risk for meters that use remote dosing.
A number of systan$ have been disclosed that are aimed at reducing the risk of
contamination to a patient and/or to others in connection with diagnostic
tests.
U.S. Pat. 4,952,373, issued August 28, 1990) to Sugarman et al., discloses a
shield that is designed to prevent excess liquid on diagnostic cartridges from
being
transferred to a monitor with which the cartridge is used. The shield is
fabricated
i o from thin plastic or maallic film and is attached to a cartridge that is
gtna~aUy the
size of a cxedit card.
U. S. Pat. 5,104,620, issued March 31) 1992, to Brenneman) discloses an
inverse fiu~nd shaped body with a central capillary tube to transport a liquid
sample
from a remote sample-application point to a test surface. The device can be
used to
i s transfer blood from a finger stick to a reagent film.
U.S. Pat. 3,991,617, issued November 16, 1976, to Marteau d'Autry discloses
a device that is used with a pipette intended to be used with disposable tips.
The
device provides a push button mechanism for ejecxing the tip from the end of
the
pipette.
2 o The common dement of the above patents is that each of the devices
disclosed
addresses the risk of corrtamination that is posed by biological Ouids and
other
potentially hazardous liquids.
Sumrr~sry of the Invaition
25 In accordance with the present invention, a device for use in an apparatus
for
measuiv~g a conc~ration of an analyte in a sample of a biological fluid
comprises
(a) a hollow frustum, having open ends of unequal size and
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(b) a porous membrane for accepting the sample, attached to) and
substantially closing, the smaller open end, the membrane comprising
(i) a surface for accepting the sample and
('a) a reagent for reacting with the analyte to cause, in a
s physically detectable patan~eter of the membrane, a change that can be
meas<rred and
be related to the concentration of the analyte in the sample.
A method of this invention for measuring a concentration of an analyte in a
sample of a biological 9uid comprises
(a) providing a device that comprises a hollow frustum having open
ends of unequal size, whose smaller end is substantially closed by a membrane
that
has
(i) a surface for accepting the sample and
('u~ a reagent for ring with the analyte to caux, in a
physically detectable parameter of the membrane, a change that can be measured
and
1 s be related to the conca~tration of the anslyte in the sample;
(b) applying the sample to the manbrane surface;
(c) measuring the change in the paramaer, and
(d) determining the analyze conca~tration from the measurement of
the parameter change.
2 o The device of the present invention can be used advantageously with a
meter
for measuring a concentration of an analyte in a sampk of biological 9uid that
is
applied to a first surface of a porous membrane that contains a reagent, which
reacts
with the analyze to cause a change in re8axance of a second surface of the
membrane, the membrane being attached to and substantially closing an end of a
2 s hollow frustum device. The meter comprises
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(a) a body having a frustum-shaped distal section for mating
engagement with the device, the section tapering inwardly to an end that faces
the
second surface of the membrane,
(b) an optical system in the body to direct a beam of light out from the
s distal end and to accept tight reflected back from the second surface of the
membrane,
(c) means for measuring the light reflected back into the body both
before and after the sample is applied to the membrane, and
(d) means for computing the analyte concentration in the fluid from
i o the measured values of reflected light.
The device of the present invention permits a person to measure the analyze
concentration in a biological fluid, while minimiang the risk that the fluid
or the user
will come into contact with the measurement apparatus. Thus, the device
reduces
both the likelihood of contamination of the apparatus by the user and vice
versa. The
is device is disposable, and the terms "device" and "disposable" are used
interchangeably throughout this specification and the appended claims.
Brief Description of the Drawin~s
Fig. 1 is a perspa~ive view of a device of this invention with a portion
broken
2 o away for clarity,
Fig. 2 is a cross-sectional view taken along line 2-2 of Fig. 1;
Fig. 3 is a perspective view of a meter and device of the invention prior to
their
~8 ~~
Fig. 4 is a perspa~ive view of the meter and device in the process of
obtaining
2 s a blood sample;
Fig. 5 is a partial cross-sectional view of the meter and device of Fig. 4,
taken
along line 5-5 of Fig. 4;
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Fig. 6 is a side view in partial cross section of a plurality of devices in a
package;
Fig. 7 is a perspective view of a meter of this invention ejecting a device;
Fig. 8 is a longitudinal cross section, with certain parts in elevation for
clarity,
s of the mete of Fig. 7 in a first, in-use, position;
Fig. 9 is a side devational view, paniaify in cross section, of the meter of
Fig. 7
in a second, ejection, position;
Fig. 10 is a perspxtive view of an alternate embodiment of a meter;
Fig. 11 is a perspective view of an alternate embodiment of a device of this
i o invention;
Fig. 12 is a fi~ag<naitary perspective view of the distal end of the device of
Fig.
11;
Fig. 13 is a cxoss-sectional view taken along line 13-13 of Fig. 12;
Fig. 14 is a cross-secxional view taken along line 14-i4 of Fig. 12;
~s Fig. 15 is a cross-sectional view of a Earths embodiment of the distal end
of a
device of the invention;
Fig. 16 is a perspective view of another etnbodimart of a meter and device
prior to their being attached;
Fig. 17 is another ernbodiment of a meter and device;
2 o Fig: 18 is a perspearve view of the distal end of a further embodiment of
the
meter and device;
Fig. 19 is a side view of the distal end of the meter and device of Fig. 18
shown
in an assembled position.
Detailed Description of the Irrvartion
2 s The device of the prcsertt invention is gene~liy adapted for use in an
apparatus
for measuring the concentration of analytes, such as alcohol, cholesterol,
proteins,
ketorres, enzymes, phenylalanine, and glucose, in biologial Huids such as
blood,
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urine, and saliva. For brevity, we describe the details for using the device
in
connection with self monitoring of blood glucose; however) a person of
ordinary skill
in the art of medical diagnostics would be able to readily adapt the
technology for
measuring other anaiytes in other biological fluids.
s Self monitoring of blood glucose is ga~aavy done with meters that operate on
one of two principles. The first is the photomttric type, which is based on
reagent
strips that include a composition that changes color after blood is applied.
The color
change is a measure of the glucose concentration.
The second type of blood glucose monitor is electrochemical and operates on
i o the understanding that blood applied to an electrochemical cell can cause
an electrical
signal - voltage, current, or charge, depending on the type of meter - that
can be
related ~ to the blood glucox conca~n~ation.
The presait invartion permits convenient, remote dosing for both photometric
and electrochemical systems. For brevity, the description below focuses on a
i5 photometric system. Similar devices can be used with an elaxro~acal systdn.
With either type of systan; the prexnt device permits the mfr to monitor the
complete course of the reaction) tom the time the sample is applied until a
glucox
detecrnination is made. The ability to measure the test start time makes it
easier to
determine the glucox concentration acauately.
2 o There are some advantages to using a photometric rather than an
electrochemical system to make a ghrcox determination. One advantage of a
photometric system is that measurements can be made at more than one
wavelength
of light, and corrections can be made for variations in blood hematocrit. The
disposable discloxd here provides these advantages of the photometric system,
while
25 also permitting minimal meter contamination.
The disposables used in photomenic measura~nent systems are generally made
in the form of a thin rectangular strip. Tlx shape derives from the original
so- called
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"dip and read" test strip configuration. One end serves as a handle, while the
chemical reaction with the fluid sample is carried out at the other end.
These rectangular disposables form the male portion of the interface with the
meter. That is, the strip is raaincd by features on the meter that enclox the
s disposable. This method of retartion invites contamination of the meter with
the
fluid sample.
In order to avoid the problems of contamination the present disposabk takes
the form of a hollow Sustum) which provides the female portion of the inte~x
with
the meter. That is, the disposable encloses a portion of the meter and xrves
as a
i o cover to prevent contamination of the meter by the fluid sample.
Fig. 1 dtpicts in partial cutaway an anbodiment of this invention in which the
disposable 10 is a hollow $ustum of a cone. Membrane 12 is attached to the
smaller
end 14. Optional lip 16 provide s surface to which membrane 12 is attached
with
adhesive 18. Optional indaaations 20 are around the c~rarmference of the
is cone to provide a retention mechanism, in oorgurxxion with a groove on a
mete.
Fig. 2 is a aoss section of the disposabk of Fig. 1 taken along the line
2-2. As shown in Fig. 2, the manbrane is attach to the outside of the
disposable.
Alternatively, as shown in Fig. 11) the me<nb~rane may be attached to the
inside of the
disposable.
2 o Fig. 3 is an exploded paspa~ive view of a photomeaic meter and a
disposable
device of the type shown in Fig. 1. Mete 30 has an elongated configuration
with a
distal section 32 that is a substantially cylindrically syrnrnetrical frustum,
along whoa
perimeter is optionally a groove 34. Note that the disposable nests on the
distal
secxion of the meter in such s way that there is sn acauately defined gap G
bawe~
2s the distal end 36 of meter 30 and the bottom surface of membrane 12. The
accxuate
positioning contributes to measurement pree~sion and reliability. In the
cutout can be
seen a light source 38 and detector 40, which provide for illuminating a
disposable
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and for detecting light reflected from the disposable, respectively. As
discussed
below, measuring light reflected from the disposable yields the glucose
concentration
in the sample applied to the membrane. Although only one source and detector
are
shown in Fig. 3, multiple sources, optionally having different output spectra,
and/or
multiple detectors may be used.
Fig. 4 is a perspective view of the way in which a device and meter of Fig. 3
can be used to obtain a sample S from a stuck finger tip. It is quite easy for
the user
to bring the disposable into contact with the finger, which is a big advantage
for users
that have impaired vision.
i o Fig. 5 is a cross section of part of distal section 32 of meter 30 and
disposable
10, which illustrates the way indentations 20 and groove 34 positively locate
meter
30 within disposable 10, leaving gap G. Note that gap G ensures that blood
that
penetrates through the manbrane does not contaminate the mete. The gap
dimension, while not critical, is preferably at least about'h mm.
is An advantage of the device of the invention, when used with a meter of the
type shown in Fig. 3, is that the devices can be in a stack, nested
conveniently in a
contaita 42, as shown in 1 ig. 6. A device can then be scarred simply by
insertin8
the distal section 32 of m~er 30 into container 42 and engaging groove 34 and
indentations 20. After a test has beg completed, a used disposable can be
ejected
2 o into waste container W, as shown in Fig. 7, provided there is an optional
push-button
ejection mechanism.
Push-button ejection mechanisms of the type that are widely known and used
are suitable for this inva~tion (see e.g.; U.S. Pat. 3,991,61'n. One such
mechanism is
depicted in Figs. 8 and 9) which show a push button mxhanism mounted in a
meter
2 s of the type shown in ) ig. 3. The dements of the mechanism include shaft
44, which
joins ejector 46 and push button 48. Push button 48 works through shaft 44 to
cause
ejector 46 to disa~gage disposable 10 from the distal section 32 of meter 30.
Spring
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50 works to return the ejector 46 and push button 48 to their retracted
position.
Push-button ejection, by permitting the disposable to be removed without
direct
contact, helps to avoid contamination. I?isposables to be used with push-
button
ejection mechanisms of the type shown in Figs. 8 and 9 preferably have a
flange 19.
s Fig. 10 depicts an exnbodimait of a meter of this imraltion, which includes
a
display 50 for depicting the analyte concentration measured by the meter. The
display can be a light-anitiing diode (LED) display, a liquid crystal display
(LCD), or
similar display well known in the art.
Ahhough the above description and Flgs. contemplate a disposable having a
i o circular cxoss section and meter having a distal section having a mating
cross section)
that geometryr is not essential and, in Eater, may not even be preferred. A
priir~ary
consideration in selecting the goometry in a photometric aystan is the optical
design_
Gena~fy, re8exxometry dictates at least a minimum angular separation
(typically
45~) bavveai a detector and spearlar'ly reflected light. This, in turn
requires at least a
is minimum vextex angle of the cor>ial disposable. Howev~a, it is an advantage
to a
user to be able to vitro his/her 5nger for dosing) and a large vertex angle
interfere
with that view. Thus) a disposable having a raxangular cross suction may be
preferred, such as the hollow Bustum of a roaangular pyramid 110 shown in Fig.
11.
In that case, the angular separation between dexextor and specular-reflected
tight
2 o determines only the mutimum feasible value of L, the longitudinal
dimension of the
larger open end. But the disposable could be smaller and provide less
interfaenoe
with a user's view of his/her finger. Furthernore, rectangular membranes can
be
fabricated from n'bbons or sheets at less expanse and with less waste of
material.
Nevathdess, a cinarlar cross aec~ion is advantageous whorl an array of several
2 s sources and/or detectors is used in the optical systan.
Since contamination is possible if excess sample were to drop from the
disposable, it is desirable to accommodate large samples) without dripping.
Various
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designs can serve to retain excess sample. One is shown in Figs. 12, 13, and
14. Fig.
12 depicts tt~e disposable of Fig. 11 with indentations 124 on the small-card
sur~;ce of
the disposable. As shown in Figs_ i3 an3 i4) the indentations aDow capillary
ti:~w~ to
fl1 tt~e resulting gap betwe~ the membrane and the top inside surface of the
G~vice-
s An alternative way of forraang suc.5 gaps is to adba~e the membrane to the
d~s;~c3sahie
with thick adhesive, leaving gaps to accommodate the excess sample. A prefer;
:~d
configuration is shown in noes erection in Fig. 15. That disposable could
l~:v~; ,ci:l:er
the cirwlar geometry shown in Figs. 1-10 or the rectangular geometry of~gs_ y
3
and 12. The distinctive feature of this configuration is that the disposable
has ~:~
1G inward-extending lip 126, to which the n~rnbt~ne is adhered) and art
anauls~ ~aed
portion 128, which forms with the membrane an snnular capillary-fill chamber o
sore excess sample. A disposablre of tfitiis design is easier to fabricate
thaw tl~: of
Figs_ 13 and 14. For example, the mem~~rane could more easy be attavhed x~
t.~c; Lip
by sonic welding, a preferred at~ent method. Alternatively, adH~sivr~; e~~ er
is attachment methods) wd1 known in the art, may also be used. The cap"xr:ary
ber
of this d~ would typidly havre a larger caps~ty, as well. Note that ".":~: v.~
, a~
it is used above, is not i~aaded to be (i~teal to car geometry, but r-:~;- va
include, for example, the reaar~lar geomeay embodied in the conSguradc~: cf
Fi~_
11 and 12.
2 o Fig. 16 is an exploded pave view of a meter and a disposable e~~ t~:,
typ':
shown in Fg. 11. The distal section 132 of meter 130 has an optiorsat g~~ 134,
which is similar to groove 34, for retaining the di~posabte. Elongated nec'~c
'~ sv
fa~tates pickup of disposables from the elongated containers 42 shown i:~
~:~,. 6.
Display 150 depicts the taea~ured analyte conoezmratioa
zs Fig. 17 depicts as alternative embodiment of a meter adapted for us.: ~~':
the
disposable of 1=<g. I 1.
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Fig. 18 depicts the distal portion of yet another embodiment of a disposable
210 and meter 230. Distal section 232 mates with disposable 2I0.
Note that slots 234 are an ahernative to groove 34 (or 134) for capturing
indentations, such as 220) on the disposable.
) ig. 19 is a side view of the embodiment of Fg. 18.
In the method of this invention, a blood sample is picked up on the outward-
facing surface of the membrane. Glucose in the sample interacts with a reagent
in the
membrane to cause a color change, which changes the reflectance of the inward-
i o facing membrane surface. The light source in the meter illuminates the
inward-facing
membrane s~uface and measures the intensity of light reflected from that
surface.
Using the appropriate computation, the change in reflectance yields the
glucose
concentration in the sample.
A varidy of combinations of membrane and reagent compositions are known
i s for photometric detaW nations of blood glucose conca~tration. A prekrred
membranelreaga~t composition is a polyanude matroc incorporating an oxidase
enzyme a pero~tidase, and a dye or dye couple. The oxidase enzyme is
preferably
glucose oxidase. The peroxidase is preferably horseradish peroxidase. A
preferred
dye couple is 3-methyl-2 benzothiazolinone hydrazone hydrochloride ph~s 3,3-
2 o dimdhylaminobenzoic acid. Daads of that membranelreagent combination and
variations on 'rt appear in U.S. Pat. 5,304,468, issued Apny 19, 1994, to
Phillips et al.,
incorporated herein by reference.
Another preferred membrarKlreageM composition is an anisotropic polysulfone
membrane (available from MaMec America Corp., T'uno~um, MD) incorporating
2 s glucose oxidase, horseradish peroxidase, and tlx dye duple [3-methyl-2-
benzothiazolinone hydrazone] N-sulfoiryl ba~zaiesulfor~ate monosodium combined
with 8-arolino-1-naplrthalene sulfonic acid ammonium. Details of that
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membranelreagent combination and variations on it appear in U. S. Pat. Appl.
Ser.
No. 08l302,575, filed September 8, 1994, incorporated herein by reference.
It will be understood by those skilled in the art that the foregoing
descriptions
of embodiments of this invention are illustrative of practicing the present
invention
but are in no way limiting. Variations of the detail presented herein may be
made
without departing from the scope and spirit of the present invention.
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